<!DOCTYPE html>
<html lang="zh-CN" class="IdentityVerification">

<head>
    <meta charset="UTF-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>身份认证</title>
    <link rel="stylesheet" href="../../public/js/plugins/bootstrap/bootstrap-4.6.2-dist/css/bootstrap.min.css">
    <link rel="stylesheet" href="../../public/css/index.css" />
    <link rel="stylesheet" href="../../public/css/for.css" />
    <link rel="stylesheet" href="./index.css">
    <link rel="stylesheet" href="../../public/css/iframeMedia.css">
</head>

<body>
    <div class="main-container core-flex core-flex-justify-center core-flex-align-center">
        <div class="right">
            <div class="identity-container">
                <div class="title">
                    <div class="white-color">身份认证</div>
                    <div class="white-color">切换手机号</div>
                </div>
                <form id="authForm">
                    <div class="form-box">
                        <div class="identitf-title">
                            <label>身份认证</label>
                            <p>医联需要确保您本人认证才能注册哦</p>
                        </div>
                        <i></i>
                        <div class="form-group">
                            <label>真实姓名</label>
                            <input type="text" class="form-control-1" id="realName" placeholder="请输入" required>
                        </div>
                        <div class="form-group">
                            <label>身份证号</label>
                            <input type="text" class="form-control-1" id="idNumber" placeholder="请输入" required>
                        </div>
                    </div>
                    <div class="form-box">
                        <div class="identitf-title">
                            <label>基础信息</label>
                            <p>医联需要确保您本人认证才能注册哦</p>
                        </div>
                        <i></i>
                        <div class="form-group">
                            <div class="upload-left">

                                <label class="upload-label">医生执业证书</label>
                                <p class="upload-description">请上传头像文字清晰的照片/复印件，四角可见无遮挡</p>
                            </div>
                            <div class="upload-box">
                                <input type="file" class="form-control-file-1" id="doctorCert" accept="image/*" />
                                <label for="upload-input" class="upload-trigger">
                                    <img class="upload-icon" src="../../public/images/Frame.png.png" alt="上传" />
                                </label>
                                <img alt="" id="upload-preview" class="upload-preview" style="display: none;" />
                            </div>

                        </div>
                        <div class="form-group">
                            <label>执业证书编号</label>
                            <input type="text" class="form-control-1" id="certNumber" placeholder="请输入">
                        </div>
                        <div class="form-group">
                            <label>所在省份</label>
                            <div class="custom-select">
                                <span id="select-provice">请选择</span>
                                <span class="arrow">></span>
                                <select class="form-control-1" id="province">
                                </select>
                            </div>
                        </div>
                        <div class="form-group">
                            <label>医疗机构</label>
                            <input type="text" class="form-control-1" id="medicalInstitution" placeholder="请输入">
                        </div>
                        <div class="form-group">
                            <label>科室</label>
                            <div class="custom-select">
                                <span id="select-departments">请选择您目前所在科室</span>
                                <span class="arrow-department">></span>
                                <select class="form-control-1" id="departments">
                                </select>
                            </div>
                        </div>
                        <div class="form-group">
                            <label>职称</label>
                            <div class="custom-select">
                                <span id="select-customs">请选择您的职称</span>
                                <span class="arrow-custom">></span>
                                <select class="form-control-1" id="custom">
                                </select>
                            </div>
                        </div>
                    </div>
                    <div class="form-box bottom-bt">

                        <div class="form-check">
                            <div class="circle-checkbox" id="agreement"></div>
                            <label class="form-check-label" for="agreement">我已阅读并同意 <a href="#">《实名认证协议》</a></label>
                        </div>
                        <button type="submit" class="btn btn-primary btn-block submit">提交</button>
                        <div class="form-button">
                        </div>
                    </div>
                </form>
            </div>
        </div>

    </div>


    <script src="../../public/js/plugins/jquery/jquery.min.js"></script>
    <script src="./index.js"></script>
</body>

</html>